Bone fracture

Fracture, commonly referred to as a broken bone, is a medical condition characterized by a break in the continuity of a bone.

Broken fixed arm

Definition

A bone fracture occurs when a force exerted against a bone exceeds its structural integrity. This results in the disruption of the bone's shape and strength, causing pain, loss of function, and possible bleeding or injury to the surrounding tissues.

Anatomy and Function of Bone

Bones are a type of connective tissue reinforced with calcium and specialized bone cells. The central part of the bone, known as bone marrow, is responsible for producing blood cells. The skeletal system serves three main functions: providing support to the body, enabling movement in coordination with muscles, and protecting internal organs such as the brain, heart, and lungs.

Causes

Common causes of bone fractures include:

• Trauma from falls, sports injuries, or vehicle accidents
• Underlying medical conditions such as osteoporosis, bone cancer, or osteogenesis imperfecta that weaken bones and make them more susceptible to fracture

Symptoms

The symptoms of a fracture may vary depending on the bone involved and the severity of the injury. Common signs include:

• Intense pain at the injury site
• Swelling and bruising
• Visible deformity
• Inability to move or bear weight on the affected limb
• In some cases, bone protruding through the skin (open fracture)

Types of Bone Fractures

Fractures are classified into various types:

• Closed (simple) fracture: The skin is intact and the bone is broken internally.
• Open (compound) fracture: The broken bone pierces the skin, increasing risk of infection.
• Greenstick fracture: Incomplete break commonly seen in children.
• Hairline fracture: Small crack in the bone, often caused by repetitive stress.
• Comminuted fracture: Bone is shattered into multiple fragments.
• Avulsion fracture: A fragment of bone is pulled off by a tendon or ligament.
• Compression fracture: Bone is crushed; common in vertebrae of individuals with osteoporosis.
• Complicated fracture: Involves damage to nearby structures like blood vessels, nerves, or organs.

Complications

Potential complications from fractures include:

• Severe blood loss due to bone vascularity
• Injury to adjacent organs (e.g., lung puncture from rib fracture)
• Growth plate damage in children, potentially leading to stunted growth
• Infection (especially with open fractures)

First Aid

Immediate first aid includes:

• Immobilizing the affected area using a splint or support
• Controlling any external bleeding with clean dressings
• Avoiding movement of the injured person if spinal or pelvic fracture is suspected
• Applying cold packs to reduce pain and swelling
• Calling emergency services (e.g., 000 in Australia)

Diagnosis

Diagnostic methods include:

• X-ray imaging
• CT scan or MRI for complex or hidden fractures
• Physical examination to assess nerve and blood vessel function

Treatment

Treatment options vary by fracture type and severity:

• Immobilization with plaster cast, brace, or splint
• Surgical fixation using metal plates, screws, rods, or pins
• Traction in certain cases
• Pain management with analgesics or anti-inflammatory drugs

Surgical Procedures

In surgical interventions:

• Open fractures are cleaned to prevent infection before stabilization
• Internal fixation aligns and stabilizes bones with implants
• External fixation uses an outside frame attached to the bone with pins

Post-operative Care

Monitoring after surgery includes:

• Checking circulation, sensation, and movement
• Managing pain effectively
• Preventing compartment syndrome or circulatory impairment

Healing Process

Healing involves several stages:

• Formation of a blood clot (hematoma)
• Development of a fibrocartilaginous callus
• Ossification into hard bone
• Remodeling of the bone to its original shape

Recovery and Rehabilitation

Post-fracture care may involve:

• Physical therapy to restore movement and strength
• Use of mobility aids such as crutches
• Follow-up imaging to assess healing

Self-Care Guidelines

• Keep the cast dry and avoid pressure
• Report any numbness, swelling, or discoloration immediately
• Avoid driving or lifting heavy objects during recovery

Long-Term Outlook

Most fractures heal fully without long-term complications. However, some may require extended rehabilitation or result in chronic pain or arthritis, especially if joint surfaces were involved.

See Also

• Osteoporosis
• Dislocation
• Soft tissue injury
• Skeletal system
• Orthopedic surgery

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